Author + information
- Sotirios Tsimikas,
- Anand Prasad,
- Paul Clopton,
- Colby Ayers,
- Amit Khera,
- James de Lemos and
- Joseph Witztum
Background: We aimed to define the prevalence, racial distribution, and relationship to subclinical and clinical cardiovascular disease of biomarkers of oxidized lipoproteins in different racial groups.
Methods: IgG and IgM autoantibodies to malondialdehyde(MDA)-LDL and apolipoprotein B-100- immune complexes (ApoB-IC) were measured in 3509 individuals (1814 Blacks, 1031 Whites and 589 Hispanic) from the Dallas Heart Study with median 10.5-year follow-up. Coronary artery calcium score (CAC), abdominal aortic plaque by MRI and major adverse cardiovascular events (MACE) were quantified.
Results: IgG MDA-LDL and IgG and IgM apoB-IC were significantly different between groups, with Blacks having highest levels of IgG MDA-LDL and ApoB-IC but lowest levels of IgM ApoB-IC (p<0.001 for all). A significant age effect was noted in the entire group, with IgGs increasing and IgMs decreasing with age, particularly in Blacks. In multivariable-adjusted binary logistic regression analysis, a doubling of IgG MDA-LDL levels was associated with positive CAC (OR (95%CI) 1.16 (1.01-1.33, p=0.035) and time to MACE (1.41 (1.13-1.76), p=0.002). Multivariable-adjusted Cox regression analysis revealed that IgG MDA-LDL was a predictor of time to MACE (cardiac death, MI, stroke/TIA, coronary and peripheral revascularization) in the entire group OR (95% CI) 1.86 (1.22-2.84, p=0.004) for 4th vs. 1st quartile, which was primarily driven by Blacks subjects 2.64 (1.42-4.92, p=0.002). In the entire group, net reclassification index for time to MACE was 20.4% when adding IgG MDA-LDL to traditional risk factors.
Conclusions: Age and racial differences exist in levels of autoantibodies to oxidized lipoproteins. Elevated IgG MDA-LDL levels are associated with higher risk of subclinical atherosclerosis and predict new MACE, particularly in Blacks. These findings may contribute to the understanding of differences in race-specific MACE events.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Traditional and Novel Factors Used to Assess the Risk of, and Used for the Treatment of, Coronary Artery Disease
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1126-325
- 2017 American College of Cardiology Foundation